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ECS Guidelines

5

QuestionAnswer
ECS 1: How many electrodes must you use minimally? 8 Scalp.
ECS: How much of the scalp should you use? Entire. Skip leads.
ECS 3: What should the impedance be minimally? Below 5 ohms.
ECS : Which additional leads should be used? Respiratory, EMG, EOG, EKG.
ECS 5: Should you use 60 Hz filter? No, unless absolutely necessary.
ECS 4: What must be completely tested before recording? Entire system integrity.
ECS 2: What should the inter-electrode distance be? 10 cm.
ECS 5: What should the sensitivity be set at? No higher than 2 uV/mm
ECS 7a: What should the HFF be set at? Not below 30 Hz.
ECS 7b: What should the LFF be set at? Not above 1 Hz.
ECS 6: What is the minimum recording time? 30 minutes.
ECS: What paper speed should be used? Slow.
ECS: What reference is best to use to avoid EKG artifact? Cz.
ECS: What is it called when you turn a pt's head and the eyes stay facing straight ahead? Doll's Eyes.
ECS: What should you do with the respirator belt if the pt has a vent tube? Wrap it around the tube.
ECS: Which extremity should you stimulate? Every One.
ECS: What types of stimulation should you use? Stern Rub, Pinch, Nail Bed Press, Visual (PS) w/ EO, Yell Name, Clap.
ECS: What do you do after you do a stimulation? Note the record.
ECS: What should the temp and bp follow? The 90/90 Rule - Must be above.
ECS: How much time needs to lapse before doing a repeat study? 6 Hours.
ECS: What is the maximum allowable leakage current? 100 uA.
ECS: When should a ground lead not be used because the pt is already grounded? In ICU.
ECS: What is the inter-electrode distance in a routine recording? 6 - 6.5 cm.
ECS: Best montage: FP2-C4, C4-02, FP1-C3, C3-01, T4-Cz, Cz-T3 + EKG and 1 non-cephalic (ex: hand).
ECS: To avoid high susceptibility to artifact, what montage is best? F7-T5, F8-T6, F3-P3, F4-P4, Fz-Pz and 1 non-cephalic (ex: hand).
ECS: What sensitivity should you calibrate this record at? 2 uV (the same as recorded).
ECS: What is the best insurance against many artifacts, especially in the ICU? Low Impedance.
ECS: One of the 2 physicians must be a: Neurologist, neurosurgeon, or intensivist.
ECS: For an adult, the minimal time lapse between two examinations for direct, structural cerebral damage (intracerebral hemorrhage, stroke, trauma, etc.) is: 4-6 Hours.
ECS: For an adult, the minimal time lapse between two examinations for non-direct, non-structural cerebral damage (hypoxic-ischemic encephalopathy) is: 12 Hours.
ECS: Corroboratory or ancillary tests are optional and not required for an adult unless: A portion of the exam cannot be completed, is altered by a neuro-depressant drug, or the etiology is not certain.
ECS: Age statistics are adjusted for prematurity, which is less than: 38 weeks.
ECS: Age-specific requirements for confirmatory - 7 days - 18 years: Brain perfusion assessment or 2 EEGs.
ECS: Age-specific requirements for exam interval - 7-60 days: 48 hours.
ECS: Age-specific requirements for exam interval - 61 days - 1 year: 24 hours.
ECS: Age-specific requirements for exam interval - 1-18 years: 12-24 hours.
ECS: What is the interval between the 2 examinations for a 1-18 year old pt? 24 hours.
ECS: What is the interval between the 2 examinations for a 61 day to 1 year old pt? 24 hours.
ECS: What is the interval between the 2 examinations for a 7-61 day old pt? 48 hours.
ECS: What type of confirmatory test would a pt 1-18 years old need? 2 EEGs lapsed by 48 hours.
ECS: What type of confirmatory test would a 61 day to 1 year old need? A brain perfusion assessment or 2 EEGs.
ECS: What type of confirmatory test would a 7-60 day old need? A brain perfusion assessment or 2 EEGs lapsed by 48 hours.
ECS: What type of pt may not be declared brain dead? Infants less than 7 days post term past 38 weeks (corrected for prematurity).
ECS: When must a neurologist, neurosurgeon, or intensivist perform at least one of the 2 studies? When the subject is a pediatric pt.
ECS: In what condition must the retest lapse for 12 hours? Non-structural cerebral damage (hypoxic-ischemic encephalitic).
ECS 8: What activation procedure(s) should you do? Demonstrate reactivity to pain stimulus. Also Auditory (AS) and Visual.
ECS: What should the pt's temp be? 35 degree Celsius.
ECS: What drugs should be avoided? Any that depress cortical function (barbs, benzos). Get serum levels.
ECS: Artifact: Note ANY presumed artifact.
ECS: When is a study considered in ECS? Only if there is no electro-cortical potential under these strict guidelines.
Created by: kmburg5840
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